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Lingual Plate Fracture Management — ORE Part 1 MCQ

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ModerateOral SurgeryLingual Plate Fracture ManagementORE Part 1

During extraction of a mandibular premolar, a small greenstick fracture of the lingual cortical plate occurs. The tooth is removed. The fractured plate remains attached to the soft tissues, there is no segmental mandibular mobility, and the patient has normal occlusion. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Reposition the plate, smooth sharp edges, close the wound and review healing

**A is correct.** A small greenstick lingual plate fracture that remains attached to soft tissues, with stable occlusion and no mandibular mobility, should be managed conservatively. Gentle repositioning preserves the viable plate; smoothing sharp edges reduces mucosal trauma; and soft-tissue closure protects the site while healing is reviewed. Published evidence describes uneventful outcomes without removal or rigid fixation of small lingual cortical fragments. Option A sacrifices potentially viable bone and increases local trauma. Option E is excessive: fixation is for a clinically significant mandibular fracture, not an isolated incomplete cortical plate injury with stable occlusion. Option C leaves exposed sharp bone and does not provide wound protection. Option B may be used in selected painful sockets but does not manage the displaced bony plate or provide appropriate wound closure.

Reference: Cordaro L, et al. “Fracture and displacement of lingual cortical plate of mandibular symphysis following bone harvesting: case report.” 2004. https://pubmed.ncbi.nlm.nih.gov/15359154/